Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Ultrasound assesment of the mobile intima and atherosclerotic plaquesin the carotid arteries

Authors: L.A. Bockeria 1, 2, A.S. Bakhmet’ev 1, 3, M.V. Shumilina 2, M.L. Chekhonatskaya 3, V.I. Kovalenko 1, 2

Company:
1 Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, ul. Barrikadnaya, 2/1, stroenie 1, Moscow, 125993, Russian Federation;
 2 Bakoulev National Scientific and Practical Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation;
 3 Saratov State Medical University named by V.I. Razumovskiy, Ministry of Health of the Russian Federation, ul. Bol’shaya Kazach’ya, 112, Saratov, 410000, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2017-14-3-152-157

UDC: 616.133-004.6-073.43

Link: Clinical Physiology of Blood Circulaiton. 2017; 14 (3): 152-157

Quote as: Bockeria L.A., Bakhmet’ev A.S., Shumilina M.V., Chekhonatskaya M.L., Kovalenko V.I. Ultrasound assesment of the mobile intima and atherosclerotic plaques in the carotid arteries. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2017; 14 (3): 152–7 (in Russ.). DOI: 10.24022/1814-6910-2017-14- 3-152-157

Received / Accepted:  15.06.2017/16.06.2017

Full text:  

Abstract

Objective: ultrasound analysis of the echostructure of mobile intima flotation structures in bifurcation of the common carotid artery.
Material and methods. 32 carotid arteries with unstable mobile flotating elements in 30 patients were analyzed. All patients underwent ultrasound angioscanning of brachiocephalic arteries according to the standard method with estimation of the diameter of the main arteries, degree of stenosis, plaque structure and parameters of hemodynamics. The frequency of occurrence in the population of similar changes in patients with atherosclerotic profile was revealed.
Results. In most cases mobile structures with a floating element were located in bifurcation of the common carotid artery and accompanied an atherosclerotic process of varying severity. In more than half of the cases (56.25%), such changes resulted from a thickening of the intima-media complex in the posterior wall of the common carotid artery. Only in 4 (12.5%) cases flotation elements were present together with atherosclerotic plaques, which influenced local parameters of hemodynamics and stenosed the vessel by more than 50%. Also, possible reasons for the formation of flotation elements on the plaque surface in 3 patients with restenosis after carotid endarterectomy were considered. The work presents the possible difficulties of diagnosis in the study of patients with suspected atherosclerotic substrate with mobile structures in its composition.
Conclusion. Ultrasound angioscanning of brachiocephalic arteries, especially a bifurcation of the common carotid artery, allows to reveal in a number of patients flotating hyperechoic structures representing possible hazards embolism.

References

1. Petty G.W., Brown R.D. Jr, Whisnant J.P., Sicks J.D.,
O'Fallon W.M., Wiebers D.O. Ischemic stroke subtypes:
a population-based study of incidence and risk factors.
Stroke. 1999; 30: 2513–6.
2. Falk E. Pathogenesis of atherosclerosis. J. Am. Coll.
Cardiol. 2006; 47: 7–12.
3. Тимина И.Е., Бурцева Е.А., Скуба Н.Д., Покров-
ский А.В., Кунцевич Г.И. Сопоставление структуры
атеросклеротической бляшки в сонной артерии по
данным комплексного ультразвукового и гистоло-
гического исследований. Ультразвуковая и функ-
циональная диагностика. 2004; 3: 81–7.
4. Халилов И.Г., Закиржанов Н.Р., Шарафисламов И.Ф.,
Баязова Н.И., Ярошкевич Г.Е. Структура атеро-
склеротических бляшек артерий, оцениваемая
ультразвуковым исследованием у пациентов с ост-
рым ишемическим инсультом. Казанский медицин-
ский журнал. 2016; 97 (6): 846–50.
5. Costanzo L., Sole A., Tamburino C., Pino L. Carotid
thin fluttering bands: a new element of arterial wall
remodelling? An ultrasound study. Int. J. Cardiovasc.
Imag. 2015; 31: 1393–400.
6. Kotval P.S., Barakat K. Doppler and M-mode sonography
of mobile carotid plaque. Am. J. Roentgenol. 1989;
154: 433–4.
7. Szendro G., Sabetai M., Tegos T.J. et al. Mobile carotid
plaques: the natural history of two asymptomatic and
non-operated cases. J. Vasc. Surg. 1999; 30: 357–62.
8. Ko P.T., Lin S.K., Chang Y.J. et al. Carotid floating
plaques associated with multiple cerebral embolic strokes.
Angiology. 1997; 48: 255–61.
9. Chakhtoura E.Y., Goldstein J.E., Hobson R.W. Management
of mobile floating carotid plaque using carotid
artery stenting. J. Endovasc. Ther. 2003; 10: 653–6.
10. Schlachetzki F., Hoelscher T., Lange M., Kasprzak P.
Ultrasound finding of a mobile atheroma in the common
carotid artery. Circulation. 2000; 102: 105.
11. Khurana D., Saini M., Laldinpuii J. et al. Mobile plaque
in the internal carotid artery: a case report and review.
Ann. Indian Acad. Neurol. 2009; 12 (3): 185–7.
12. Escribano J.M., Juan J., Rodriguez Mori A., Bellmunt S.,
Matas M. Mobile carotid plaque. Rev. Neurol. 2001;
33 (9): 836–9.
13. Дубров Э.Я., Ахметов В.В., Алексеечкина О.А., Леме-
нев В.Л. Ультразвуковые критерии эмбологенности
атеросклеротической бляшки каротидных артерий.
Ультразвуковая и функциональная диагностика.
2006; 1: 97–103.
14. Ахметов В.В., Дуданов И.П., Азиева А.З., Абуа-
заб Б.С., Теремовский Н.Ю., Завалишин С.Е. и др.
Эхографические и ангиоскопические характерис-
тики атеросклеротических изменений сонных
артерий у больных с преходящими нарушениями
мозгового кровообращения. Ученые записки Пет-
розаводского государственного университета. 2014;
8–2 (145): 36–40.

About Authors

  • Bockeria Leo Antonovich, Dr. Med. Sc., Professor, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, Director of Bakoulev NSPCCS, Chief of Chair of Cardiovascular Surgery of RMACPE; orcid.org/0000-0002-6180-2619
  • Bakhmet’ev Artem Sergeevich, Assistant Professor of Chair of Radiation Diagnostics and Radiotherapy named by N.E. Shtern; orcid.org/0000-0003-3814-5515
  • Shumilina Margarita Vladimirovna, Dr. Med. Sc., Chief of Group of Ultrasound Cardiovascular and Organ Pathology; orcid.org/0000-0001-9871-8173
  • Chekhonatskaya Marina Leonidovna, Dr. Med. Sc., Professor, Chief of Chair of Radiation Diagnostics and Radiotherapy named by N.E. Shtern;
  • Kovalenko Vladimir Ivanovich, Dr. Med. Sc., Professor of Chair of Cardiovascular Surgery of RMACPE

 If you found mistakes, select text and press Alt+A